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29-361 (6) ibembe CI-x#y of Xort4a ipton z Y - $ � �lassadptsetts 4 -_ - � DEPARTMENT OF BUILDING INSPECTIONS - INSPECTOR 212 Main Street ' Municipal Building Northampton, Mass. 01060 SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION Page C�Y_ Plot Zone L CA Permit Number Q 0 Location ere hr()o j_ j)r 06 Kefi e,, Iva-- Owner or Lessee �-_ d jarcl !' � Wool—ef r)4 �ll►�i d t < C - 66, Tele. No.) Contractor License Number) Address RESIDENTIAL NON-RESIDENTIAL _ One Family Home Business Two or More Number of Units Other (Specify) Floors in Bldg. Type o Appliance: New _� Wood Burning Used Coal " Labeled Combination ,, Date of purchase Furnace ' Fireplace Insert Model or Type of Appliance iY —13 WODD S-rd(/F Manufacturer NjgS; 4-V vA Purchased From S-f111E S WOP 0iod of Firm) (Address) Cost - Construction & Appliance: Chimney New Metal Bestos He EXISTIN& Interior Chimney Separate Flue Exterior Chimney Other appliance attached to lue ---..i�— Masonary/lined Unlined Notes & Data: Signature of Applicant: Building Inspector Approval: Date: C� � l` 7,1 / Department of Building Inspections 3n Street a ihampton, Mass. 01060 BUILDING Z° 00 2 IL PERMIT 29-361 VALIDATION DATE October 17, 19 83 PERMIT NO. 610 APPLICANT Edward & Maureen Mlkucki ADDRESS 227 Acrebrook Drive Owners (N0.) (STREET) (CONTR'S LICENSE) OF PERMIT TO Wood Burning Stove (_) STORY One Family DWELLLRING UNITS (TYPE OF IMPROVEMENT) N0. (PROPOSED USE) 227 Acreooe Florence ZONING brk Driv r AT (LOCATION) DISTRICT URA (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: permit for the installation of a-wood burning stove AREA OR 630.00 PERMIT 10.00 VOLUME ESTIMATED COST $ FEE $ (CUBIC/SQUARE FEET) OWNER Edward F. & Maureen A. Mikucki ADDRESS Acrecrook Drive, Florence, Mass. 01060 BUI PT WHITE - FILE COPY GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - /SSESSORS COPY